New procedure uses coolant to treat atrial fibrillation

At 2:30 a.m., Malcolm Graham would wake to the feeling that his heart was bouncing around in his chest.

"It felt like a pingpong ball being hit all over place," said Graham, 64. "Sometimes it hit light, sometimes hard."

After four hours, his heart rate would return to normal, but Graham remained anxious about when it would happen again. For more than five years, he tried medications to deal with the intermittent episodes of atrial fibrillation, an irregular quivering of the heart.

"Then in September, it all went south," said Graham, who retired last year. "It just really started going crazy. I was having an episode every other day."

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A new minimally invasive procedure that uses freezing technology to treat an abnormal heart rhythm is giving patients such as Graham hope for a better life. On Thursday, he underwent the procedure at Texas Health Harris Methodist Heart Center in Fort Worth. It's the only facility in Tarrant County using the Arctic Front Cardiac CryoAblation Catheter system, approved by the Food and Drug Administration in December.

The procedure delivers coolant through a balloon catheter to treat atrial fibrillation, the most common type of arrhythmia, which affects some 3 million Americans.

Compared with traditional radio-frequency ablation, the new technology is much safer and significantly reduces the risk of damage to areas around the heart, said Dr. Theodore Takata, a cardiac electrophysiologist at the heart center.

"It's not a slam dunk," said Takata, who performed the procedure on Graham. But with a success rate of nearly 70 percent in trials, it is very effective.

It's a promising tool, said Dr. Sreenivas Gudimetla, board president for the American Heart Association of Tarrant County.

Typically, the procedure is designed for younger people with intermittent atrial fibrillation. Candidates should have no structural heart disease and must have failed on three medications.

"The big benefit of this is a success rate that is close to 70 percent, which is far better than the traditional ablation procedures that we did," Gudimetla said. "With traditional radio-frequency catheter ablation, the success rate is substantially less and not nearly as promising."

Treatment of atrial fibrillation, recommended to help prevent strokes, includes drugs, a pacemaker and ablation.

During the ablation procedure, a catheter is inserted in the groin and guided to the left atrium of the heart. Coolant is used instead of heat to make lesions around the pulmonary vein.

Medtronic's Arctic Front catheter system was first used in the U.S. on Jan. 4 at the Mayo Clinic, said Loren Busbee, a company representative.

"This hospital is the first in Tarrant County to have it and among the first of 20 nationally to do this," Busbee said.

Three other North Texas hospitals have the equipment: Baylor Heart and Vascular Institute and UT Southwestern St. Paul, both in Dallas, and The Heart Hospital Baylor Plano.

Graham, who had had no cardiac disease before the fibrillation, said he hopes that his irregular heart rhythm will no longer interfere with his life and that he'll be able to visit his five children and nine grandchildren.

"I've been waiting for this procedure to come along," he said. "I figured, let's just go for it."